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Republican Priorities Will Test Next Labor-HHS Chairman

Tom Williams/CQ Roll Call
Whoever serves as chairman after Rehberg will play a significant role in GOP attempts to cut off funding for Obama’s signature health care law.

Alexander is particularly interested in medical research, an area in which Democratic and Republican appropriators have been able to find common ground. He has defended a program at the National Institutes of Health that gives medical research money to states with a poor track record of competing for grant money, including Louisiana.

He is also a fierce critic of the health care law (PL 111-148, PL 111-152) and was chosen to lead floor debate on a bill to block its implementation in 2011. If he becomes chairman, he could use the appropriations process to try to strike at the health care law as Rehberg did.

The subcommittee’s fiscal 2013 draft bill cut funding for several health care law provisions, including the Center for Medicare and Medicaid Innovation. And Republicans successfully cut money for the law’s Medicare cost-containment board in the fiscal 2012 omnibus appropriations package (PL 112-74).

But much of the law’s funding is mandatory, so appropriators can’t remove it. And while Republicans want to strike the law’s funding, Democrats in the House and Senate insist on protecting it, making it difficult to reach compromise.

“Many Republicans won’t vote for anything that has funding for the [Affordable Care Act]. So it’s just added a whole other layer of complexity,” Holubowich said.

One of the biggest challenges appropriators have these days, Porter said, is to push against calls to cut domestic spending across the board by the same amount.

“We’re in a period where the appropriators are going to be required to make cuts, and the last thing we ought to ever do is cut mindlessly, every single program the same,” Porter said. “The whole job of appropriators is to determine the priorities of the programs under the jurisdiction of their committee.”

If Young or Alexander becomes chairman and want to increase funding for medical research, for example, they will need to cut other programs to arrive at an acceptable total spending figure.

“It’s no fun to be slashing funding for CDC by 10 percent, or not being able to give NIH an increase,” said Holubowich, referring to the Centers for Disease Control and Prevention. “The overall fiscal environment makes it really hard to be an appropriator right now.”

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